Appeal from the Circuit Court of Cook County. Honorable Barbara Ann McDonald, Judge Presiding.
The opinion of the court was delivered by: Justice Hoffman
The plaintiff, Earlean Jinkins, individually and as independent administrator of the estate of her deceased husband, George Jinkins (George), brought a medical malpractice action against the defendants, Dr. Choong Lee and Paulette Medlin, two employees of the John J. Madden Mental Health Center (Madden), a State of Illinois mental health care facility. The defendants subsequently filed a motion for summary judgment, arguing, inter alia, that the circuit court lacked subject matter jurisdiction over the claims against them based on the doctrine of sovereign immunity. The circuit court granted summary judgment in favor of the defendants, and the plaintiff brought the instant appeal.
The issues before us are whether the trial court erred, as a matter of law, in finding that the doctrine of sovereign immunity applied and, alternatively, whether we should affirm the trial court's entry of summary judgment in the defendants' favor because they are shielded from liability under the doctrine of public officials' immunity. For the reasons which follow, we reverse and remand this case to the circuit court for further proceedings.
On June 20, 1996, George was admitted to the emergency room at Christ Hospital and Medical Center (Christ Hospital), a private hospital, and diagnosed as being acutely psychotic and exhibiting suicidal behavior. George was later transferred to Madden, where Dr. Lee, a psychiatrist, and Paulette Medlin, a psychologist, released him after evaluating him and referring him for outpatient treatment. An hour after being released, George committed suicide by shooting himself in the head.
The plaintiff filed a complaint in the circuit court containing four counts which alleged medical malpractice against Dr. Lee and Medlin. *fn1 The plaintiff alleged, inter alia, that Dr. Lee and Medlin breached their duty to properly examine, diagnose, monitor, and treat George and to admit him to Madden, which proximately caused George's death.
In his answer to the plaintiff's complaint, Dr. Lee denied that he examined, diagnosed, treated, or cared for George, and admitted only that he interviewed and evaluated him. Dr. Lee and Medlin did admit that, in providing medical care and services to George, it was their duty to apply the knowledge and skill ordinarily possessed by well-qualified heath care professionals in the same or similar communities. As affirmative defenses, the defendants alleged that George had failed to: (1) follow the medical treatment suggested by the attending health care professionals at Madden and (2) refrain from engaging in conduct which was likely to cause injury or death to himself.
The pleadings, deposition testimony, and medical records contained in the record reveal the following facts. Lorenzo Norwood, a friend of George's, testified that George began exhibiting strange behavior about three or four months before he committed suicide. After one particular incident during which George intentionally jumped in front of a passing car, Norwood, another friend named Maurice Abernathy, and George's mother, Florine Jinkins (Florine), took George to Christ Hospital.
At the hospital, Dr. Daniel Sachs diagnosed George as acutely psychotic and exhibiting suicidal behavior. A petition for involuntary admission was prepared on behalf of George pursuant to section 3-601 of the Mental Health and Developmental Disabilities Code (Mental Health Code) (405 ILCS 5/3-601 (West 1996)), and signed by Florine. The petition alleged that George was hearing voices, thought he was being shot at, thought birds were talking to him, and believed he was being poisoned. Attached to the petition was a certificate prepared by Dr. Sachs stating that George was mentally ill, and because of his illness, was reasonably expected to inflict serious physical harm on himself or another in the near future. Dr. Sachs testified that George was subject to involuntary admission and in need of immediate hospitalization based on comments made by Florine and either Abernathy or Norwood, to the effect that George repeatedly tried to kill himself by walking in front of cars stating, "I just want to go." Pursuant to the Mental Health Code, after a petition for involuntary admission and accompanying certificate are filed on behalf of a patient, a psychiatrist must evaluate the patient and execute a second certificate in order for the patient to be involuntarily held longer than 24 hours at a mental health facility. 405 ILCS 5/3-602 (West 1996); 405 ILCS 5/3-610 (West 1996).
Social worker Leonard Kemp informed Dr. Sachs that George was going to be transferred to Madden to be evaluated by a psychiatrist. However, George was not transferred immediately because his blood alcohol level was too high. He remained at Christ Hospital until approximately 6 a.m. During this time, George appeared hostile and agitated, and was subsequently given Haldol and placed in restraints. At 7:30 a.m., George arrived at Madden, accompanied by Florine and the plaintiff.
Dr. Lee testified that he was working as an intake psychiatrist at Madden when George was transferred to the facility. He explained that the intake psychiatry position exists only in State hospitals and that, in his opinion, such positions do not exist in private hospitals. Dr. Lee explained that, as the intake psychiatrist, it was his job to examine individuals brought to Madden and decide whether they needed psychiatric care. If so, Dr. Lee hospitalized the patient, and if not, he referred the patient to an outpatient clinic. Dr. Lee stated that he exclusively did intake work and did not provide long term psychiatric care for any patient.
Before interviewing George, Dr. Lee reviewed the records from Christ Hospital, including the petition for involuntary admission. The doctor acknowledged that he knew George was given Haldol the previous night. Dr. Lee stated that, during the interview, George appeared to be calm and cooperative and showed no symptoms of psychosis or paranoid ideations. George told Dr. Lee that he was brought to Christ Hospital because he was bleeding, hyperventilating, and intoxicated. Dr. Lee asked George about the statements contained in the petition for involuntary admission and accompanying certificate, alleging that he was hearing voices, thought he was being poisoned, and attempted to commit suicide by running in front of cars. George denied the allegations and stated that he wanted to go home and spend time with his family. According to Dr. Lee, the plaintiff told him that her husband was not suicidal, that he did not need to be in the hospital, and that she wanted to take him home. Florine also told Dr. Lee that George was doing better and that she would rather take him home.
Dr. Lee diagnosed George with an "alcohol-related disorder NOS" (not otherwise specified) and alcohol abuse. According to Dr. Lee, he made the diagnosis because, by the time George left Christ Hospital, his alcohol level had decreased and his psychiatric symptoms had disappeared. Dr. Lee stated that, due to the change in George's behavior while at Madden, he did not feel that George needed to be involuntarily admitted. The doctor did not believe that George was suicidal, but acknowledged there was some low suicidal risk. Dr. Lee stated that he classified George's suicidal risk as "low" because he had a supportive family, he had not attempted suicide in the past, and did not have any prior history of psychiatric hospitalization.
Dr. Lee testified that the first certificate for involuntary admission was filled out at Christ Hospital. He explained that it was his responsibility to write a second certificate for George if he believed it to be necessary; however, he did not believe George was "certifiable." Dr. Lee stated that, in his opinion, George needed follow-up observation and, as a consequence, he referred George to a community mental health center for outpatient treatment. However, George refused the referral. Finally, Dr. Lee acknowledged in his deposition that George was his patient during the intake procedure. When asked specifically whether he was George's psychiatrist and George was his patient, Dr. Lee replied affirmatively.
Medlin testified that she was licensed as a clinical professional counselor and classified as a "psychologist three" at Madden. She stated that she worked in intake and that her job entailed gathering information about a patient to determine if he or she should be admitted to the facility. Medlin interviewed George, the plaintiff, and Florine. According to Medlin, both the plaintiff and Florine told her that George was not suicidal and that he should return home. Florine also told Medlin that George's behavior was related to his alcohol consumption. Medlin stated that, although she was not responsible for deciding whether a patient should be admitted into Madden, she did not feel that George needed to be committed.
Dr. Syed Ali, a psychiatrist and expert witness for the defendants, testified that he reviewed the policies and procedures from Madden. Dr. Ali stated that the evaluation process, standards, and procedures that are followed to involuntarily commit a patient are the same in a private hospital as they are in a State hospital. Dr. Ali further testified that intake psychiatrists must first evaluate the patient, which would involve using his or her training and experience and applying the standard of care that a psychiatrist would use in making an evaluation. According to Dr. Ali, the applicable standard of care in deciding whether George should have been admitted to Madden required that Dr. Lee make a diagnosis, determine the proper treatment plan, gather information from as many resources as were available to him, and establish a plan to ensure George's well-being and safety. According to the doctor, it was also Dr. Lee's duty as a psychiatrist to assess whether or not George presented an imminent threat of harming himself. Dr. Ali testified that George's symptoms could be explained by alcohol withdrawal, and that many people become paranoid as a result thereof. Finally, Dr. Ali stated that most patients who come to an institution with a petition for involuntary admission and certificate are admitted to the facility for observation.
Dr. Hasina Javed, a psychiatry resident who was working at Madden at the relevant time, testified that most patients who arrived with a certificate were admitted to Madden. Dr. Javed stated that George's symptoms were typical of a person with an organic psychosis, meaning someone who is intoxicated, paranoid, and delusional.
George was discharged from Madden at approximately 10 a.m. on June 21, 1996. Less than an hour later, he shot himself in the head and was taken back to Christ Hospital, where he died.
The defendants, Dr. Lee and Medlin, filed a motion for summary judgment, arguing that the circuit court lacked subject matter jurisdiction over the claims asserted against them based on the doctrine of sovereign immunity. Relying on this court's decision in Kilcoyne v. Paelmo, 204 Ill. App. 3d 139, 562 N.E.2d 231 (1990), the trial court granted their motion and made the requisite findings under Supreme Court Rule 304(a) (155 Ill. 2d R. 304(a)). Thereafter, the plaintiff filed a timely notice of appeal.
Summary judgment is a drastic means of disposing of litigation (Happel v. Wal-Mart Stores, Inc., 199 Ill. 2d 179, 186, 766 N.E.2d 1118 (2002)), and should be granted only when "the pleadings, depositions, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law" (735 ILCS 5/ 2-1005(c) (West 1998)). Appellate review of an order granting summary judgment is de novo. Outboard Marine Corp. v. Liberty Mutual Insurance Co., 154 Ill. 2d 90, 102, 607 N.E.2d 1204 (1992). In reviewing an order granting summary judgment, we construe the evidentiary matter strictly against the moving party and in the light most favorable to the nonmoving party. Espinoza v. Elgin, Joliet, & Eastern Ry. Co., 165 Ill. 2d 107, 113, 649 N.E.2d 1323 (1995). A triable issue of fact exists where there is a ...